Individual provider Active NPI

Michele Myette, LCSW

  • Mental Health Counselor
  • Lauderdale Lakes, FL
National Provider Identifier
1710418595
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW12594 Issued in FL
Practice address
4720 N State Road 7 BLDG B
Lauderdale Lakes, FL 33319-5860
Phone
(954) 463-0911
Fax
(954) 497-3857
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW12594 FL Primary

Addresses

Primary practice location

4720 N State Road 7 BLDG B
Lauderdale Lakes, FL 33319-5860

Mailing address

4740 N State Road 7 Ste 201
Lauderdale Lakes, FL 33319-5839
Phone (954) 486-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12594FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Behavioral Health, Inc. PastSince Mar 13, 2017 Accepting new patients
Henderson Behavioral Health, Inc. PastSince Jul 4, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1710418595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7 STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 N STATE ROAD 7 BLDG B",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195860",
            "telephone_number": "954-463-0911",
            "fax_number": "954-497-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYETTE",
        "first_name": "MICHELE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW12594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.